With cognitive dysfunction comes questionable behavior. Dementia and its many forms and stages can cause a person to behave in such a way that is completely out of character. Sometimes these behaviors might be funny, such as placing a shoe on the wrong foot, or walking around the house clothed inappropriately. However, some of these behaviors can be somewhat disturbing and possible downright dangerous.The following is a summary of common behaviors among people with dementia:

Wandering. People with dementia tend to walk and wander aimlessly for a variety of reasons, such as boredom, or a need to “escape.” They may also be seeking to fill a physical need such as a visit to the bathroom or the kitchen. However, they might take it one step further and wander a bit too far, out of the house, or even down the street. Worse yet, they often forget why they even left the house, or how to get back home. This could pose a number of dangers on them such as walking in front of a moving vehicle, or falling down a cliff.

Incontinence. Loss of bowel control or bladder often occurs as dementia progresses. Sometimes these accidents occur because the person doesn’t remember where the bathroom is and can’t get to it in time. However, if an accident occurs, it’s important to help the person with dementia maintain their respect and dignity by providing an environment of understanding and reassurance. Also, incontinence pads and products can be purchased at most supermarkets and pharmacies. A urologist may be able to prescribe a special product or treatment for this condition.

Agitation. Agitation refers to a range of behaviors associated with dementia, including sleeplessness, verbal or physical aggression and irritability. These types of behavior problems often progress with the stages of dementia, from mild to more severe. Agitation may be triggered by a variety of factors, including environmental factors, fear and fatigue. Most often, agitation is triggered when the person feels as if “control” is being taken away. You can help reduce the triggers of agitation by reducing caffeine intake, sugar and junk food; reduce or avoid noise, clutter or crowds; and maintaining structure with predictable routines.

Repetitive speech or actions. Often, people with dementia will repeat a word, statement, question or activity more than once in a short amount of time, sometimes within the same hour or half hour. Although this type of behavior is usually harmless for the person with dementia, it can be annoying and stressful to caregivers and family members. Sometimes, the behavior is triggered by anxiety, boredom, fear or environmental factors. A few ways to alleviate this behavior is by: providing plenty of reassurance and comfort; distracting them with a snack or activity; posting written reminders of activities around their dwelling space such as “dinner is at 6:30pm” or “Dave comes home at 5pm.” This may assist with reducing anxiety and uncertainty about anticipated events.

Paranoia. Watching a loved one suddenly become suspicious, jealous or accusatory can be somewhat unsettling. Keep in mind that what the person is experiencing is very real to them, therefore, it is best not to argue or disagree. This, too, is part of the dementia—try not to take it personally. For instance, the confused person may suspect that money is “missing” from their purse. So, allow her to keep small amounts of money in a pocket or handbag for easy inspection and reassurance.

Sleeplessness/Sundowning. Restlessness, agitation, disorientation and other troubling behavior in people with dementia often get worse at the end of the day and sometimes continue throughout the night, experts say. This behavior, commonly referred to as sun-downing, is caused by a combination of factors, such as exhaustion from the day’s events and changes in the person’s biological clock that confuse day and night. Try increasing daytime activities, particularly physical exercise. You should also discourage inactivity and napping during the day. Also, you can try turning on lights well before sunset and closing the curtains at dusk. This will minimize shadows and may help diminish confusion. For the sake of safety, keep a nightlight in the person’s room, hallway and bathroom. Also, make sure the house is safe by blocking off stairs with gates, locking the kitchen door and/or putting away dangerous items. As a last resort, you may want to consider talking to the doctor about medication to help the agitated person relax and sleep. However, keep in mind that sleeping pills and tranquilizers may solve one problem and create another, such as sleeping at night but being more confused the next day.